MEDICARE: NSN PREVENTATIVE MEDICINE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1326987991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NSN PREVENTATIVE MEDICINE PLLC

Provider Business Mailing Address
First Line	:	7301 SILVERMAPLE CV
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-5797
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301 SILVERMAPLE CV
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-5797
Country	:	US
Telephone Number	:	903-571-6302
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN PAUL ENGLISH
Credential	:	MD
Telephone Number	:	903-571-6302

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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